Incompetence and failure is a bad look for any political outfit, regardless of party. Add a generous dose of sneering to the mix, and you've nailed the Obama administration's approach to damage control. When they're not disdaining inconvenient cancer patients, they're overtly ridiculing reporters for asking legitimate questions. ABC News' Jonathan Karl asked White House spokesman Jay Carney why the administration keeps leaving the distinct impression that over-the-phone and in-person Obamacare applications are tantamount to enrollments, when that's not actually the case. A bit of background:

A series of internal Obama administration memos obtained exclusively by ABC News reveal for the first time how dysfunction with HealthCare.gov has upended the entire Affordable Care Act enrollment process, including applications by paper and phone that officials have been pushing as more reliable alternatives. While President Obama and other top aides have publicly reassured frustrated consumers that they can bypass the troubled website and apply by phone in as little as 25 minutes, those working most closely with the rollout acknowledged privately that even the nonelectronic avenues would be no more efficient or guaranteed, the documents show.

"Simple question from Jon Karl: How can Obama claim that users can bypass the website and apply by phone in 25 minutes when O-Care’s phone operators are stuck in the same circle of 404 hell on Healthcare.gov as the rest of the country? You’re not enrolling when you call the hotline. No one’s calculating your subsidies or signing you up for a particular plan. All you’re doing is handing off your information to a government worker who’ll create an account for you on the system while we wait for The Most Technologically Savvy Administration Ever to staple and duct-tape Healthcare.gov into a semi-functioning hub. In which case, in what meaningful sense are you “bypassing” the website? All the important stuff is still in limbo until the website works. Carney’s reply, in so many words: "Nobody has a problem with this except you, Jon Karl."

Is this the nasty approach Obama's spin-meisters will adopt when Americans start discovering that they can't keep their doctors? CNN notes that the White House is bracing for another looming round of angry recriminations next year. Is "access shock" the next "shoe to drop"? Remember, the New York Times reported last month that residents in nearly 60 percent of the total US counties covered by the federal Obamacare exchange will have two or fewer, er, "options" from which to choose. As it stands today, "at least 3.5 million" Americans have already lost their current coverage, a direct violation of the president's most prominent (and intentional) Obamacare lie. That number will likely balloon to at least eight million by the end of 2014, and could go much, much higher. These concerns are known as "minutiae" over at the DNC. Most of the dropped coverage pain is limited to the individual market for now, but that could change. Tens of millions Americans covered by employer-based plans are already experiencing premium increases because of the new law. Democrats said Obamacare would reduce rates for everybody. Those within the employer-based market must also wonder if their corporation or small business will make the decision to dump coverage in 2015 -- when the employer mandate delay ends -- and beyond. Prices are likely to jump again, too, which has anxious Democrats sweating bullets. Get ready for a lot more stories and quotes like this, guys:

Marlys Dietrick, a 60-year-old artist from San Antonio, said she had high hopes that the new law would help many of her friends who are chefs, actors or photographers get insured. But she said they have been turned off by high premiums and deductibles and would rather pay the fine. “I am one of those Democrats who wanted it to be better than this,” she said. Her insurer, Humana, informed her that her plan was being canceled and that the rate for herself and her 21-year-old son for a plan compliant with the new law would rise from $300 to $705. On the federal Web site, she found a comparable plan for $623 a month. Because her annual income is about $80,000, she doesn’t qualify for subsidies. A cheaper alternative on the federal exchange, she said, had a premium of $490 a month — but it was an HMO plan rather than the PPO plan she currently has. “I wouldn’t be able to go to the doctor I’ve been going to for years,” she said. “That is not a deal.” And both the HMO and PPO exchange plans she examined had family deductibles of $12,700, compared with her current $7,000.

And the tales of angst may just be getting started. According to a new poll commissioned by a pro-Obamacare group, just 17 percent of uninsured Americans attempted to sign up for care through the exchanges in October. Of that sliver, only one in five succeeded (though one wonders what percentage are actually enrolled). The people who were mostly likely to slog through the much-publicized Healthcare.gov quagmire are those with the biggest incentives to do so: Sicker, older folks with pre-existing conditions -- to say nothing of the legions of new Medicaid recipients. If this imbalance doesn't turn around in a hurry, the financial health of the law will be in grave danger. Will the public have any appetite for huge government healthcare bailouts? I'll leave you with healthcare wonk Avik Roy's comprehensive, 49-state analysis of Obamacare's impact on premiums. On the individual market, the average increase across the country will be 41 percent in 2014, with the brunt of the pain being felt by younger, healthier people -- and that does not include big increases in out-of-pocket expenses like deductibles and co-pays.